Health & Healthcare Disparities Committee
Filed: 3/12/2009
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1 | AMENDMENT TO HOUSE BILL 528
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2 | AMENDMENT NO. ______. Amend House Bill 528, AS AMENDED, by | ||||||
3 | replacing the introductory clause of Section 5 with the | ||||||
4 | following:
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5 | "Section 5. The State Employees Group Insurance Act of 1971 | ||||||
6 | is amended by changing Section 6.11 as follows:
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7 | (5 ILCS 375/6.11)
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8 | (Text of Section before amendment by P.A. 95-958 ) | ||||||
9 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
10 | Code
requirements. The program of health
benefits shall provide | ||||||
11 | the post-mastectomy care benefits required to be covered
by a | ||||||
12 | policy of accident and health insurance under Section 356t of | ||||||
13 | the Illinois
Insurance Code. The program of health benefits | ||||||
14 | shall provide the coverage
required under Sections 356g.5,
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15 | 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, | ||||||
16 | 356z.13
356z.11 , and 356z.14 , and 356z.15
of the
Illinois |
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1 | Insurance Code.
The program of health benefits must comply with | ||||||
2 | Section 155.37 of the
Illinois Insurance Code.
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3 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
4 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | ||||||
5 | 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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6 | (Text of Section after amendment by P.A. 95-958 )
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7 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
8 | Code
requirements. The program of health
benefits shall provide | ||||||
9 | the post-mastectomy care benefits required to be covered
by a | ||||||
10 | policy of accident and health insurance under Section 356t of | ||||||
11 | the Illinois
Insurance Code. The program of health benefits | ||||||
12 | shall provide the coverage
required under Sections 356g.5,
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13 | 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.9, 356z.10, | ||||||
14 | 356z.11, and 356z.12 , 356z.13
356z.11 , and 356z.14 , and 356z.15 | ||||||
15 | of the
Illinois Insurance Code.
The program of health benefits | ||||||
16 | must comply with Section 155.37 of the
Illinois Insurance Code.
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17 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
18 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | ||||||
19 | 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | ||||||
20 | 12-15-08.) | ||||||
21 | Section 10. The Counties Code is amended by changing | ||||||
22 | Section 5-1069.3 as follows: | ||||||
23 | (55 ILCS 5/5-1069.3)
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1 | (Text of Section before amendment by P.A. 95-958 )
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2 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
3 | including a home
rule
county, is a self-insurer for purposes of | ||||||
4 | providing health insurance coverage
for its employees, the | ||||||
5 | coverage shall include coverage for the post-mastectomy
care | ||||||
6 | benefits required to be covered by a policy of accident and | ||||||
7 | health
insurance under Section 356t and the coverage required | ||||||
8 | under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, | ||||||
9 | 356z.10, 356z.13
356z.11 , and 356z.14 , and 356z.15 of
the | ||||||
10 | Illinois Insurance Code. The requirement that health benefits | ||||||
11 | be covered
as provided in this Section is an
exclusive power | ||||||
12 | and function of the State and is a denial and limitation under
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13 | Article VII, Section 6, subsection (h) of the Illinois | ||||||
14 | Constitution. A home
rule county to which this Section applies | ||||||
15 | must comply with every provision of
this Section.
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16 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
17 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | ||||||
18 | 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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19 | (Text of Section after amendment by P.A. 95-958 ) | ||||||
20 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
21 | including a home
rule
county, is a self-insurer for purposes of | ||||||
22 | providing health insurance coverage
for its employees, the | ||||||
23 | coverage shall include coverage for the post-mastectomy
care | ||||||
24 | benefits required to be covered by a policy of accident and | ||||||
25 | health
insurance under Section 356t and the coverage required |
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1 | under Sections 356g.5, 356u,
356w, 356x, 356z.6, 356z.9, | ||||||
2 | 356z.10, 356z.11, and 356z.12 , 356z.13
356z.11 , and 356z.14 , | ||||||
3 | and 356z.15 of
the Illinois Insurance Code. The requirement | ||||||
4 | that health benefits be covered
as provided in this Section is | ||||||
5 | an
exclusive power and function of the State and is a denial | ||||||
6 | and limitation under
Article VII, Section 6, subsection (h) of | ||||||
7 | the Illinois Constitution. A home
rule county to which this | ||||||
8 | Section applies must comply with every provision of
this | ||||||
9 | Section.
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10 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
11 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | ||||||
12 | 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | ||||||
13 | 12-15-08.) | ||||||
14 | Section 15. The Illinois Municipal Code is amended by | ||||||
15 | changing Section 10-4-2.3 as follows: | ||||||
16 | (65 ILCS 5/10-4-2.3)
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17 | (Text of Section before amendment by P.A. 95-958 )
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18 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
19 | municipality, including a
home rule municipality, is a | ||||||
20 | self-insurer for purposes of providing health
insurance | ||||||
21 | coverage for its employees, the coverage shall include coverage | ||||||
22 | for
the post-mastectomy care benefits required to be covered by | ||||||
23 | a policy of
accident and health insurance under Section 356t | ||||||
24 | and the coverage required
under Sections 356g.5, 356u, 356w, |
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1 | 356x, 356z.6, 356z.9, 356z.10, 356z.13
356z.11 , and 356z.14 , | ||||||
2 | and 356z.15 of the Illinois
Insurance
Code. The requirement | ||||||
3 | that health
benefits be covered as provided in this is an | ||||||
4 | exclusive power and function of
the State and is a denial and | ||||||
5 | limitation under Article VII, Section 6,
subsection (h) of the | ||||||
6 | Illinois Constitution. A home rule municipality to which
this | ||||||
7 | Section applies must comply with every provision of this | ||||||
8 | Section.
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9 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
10 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-978, eff. | ||||||
11 | 1-1-09; 95-1005, eff. 12-12-08; revised 12-15-08.)
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12 | (Text of Section after amendment by P.A. 95-958 ) | ||||||
13 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
14 | municipality, including a
home rule municipality, is a | ||||||
15 | self-insurer for purposes of providing health
insurance | ||||||
16 | coverage for its employees, the coverage shall include coverage | ||||||
17 | for
the post-mastectomy care benefits required to be covered by | ||||||
18 | a policy of
accident and health insurance under Section 356t | ||||||
19 | and the coverage required
under Sections 356g.5, 356u, 356w, | ||||||
20 | 356x, 356z.6, 356z.9, 356z.10, 356z.11, and 356z.12 , 356z.13
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21 | 356z.11 , and 356z.14 , and 356z.15 of the Illinois
Insurance
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22 | Code. The requirement that health
benefits be covered as | ||||||
23 | provided in this is an exclusive power and function of
the | ||||||
24 | State and is a denial and limitation under Article VII, Section | ||||||
25 | 6,
subsection (h) of the Illinois Constitution. A home rule |
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1 | municipality to which
this Section applies must comply with | ||||||
2 | every provision of this Section.
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3 | (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | ||||||
4 | 95-520, eff. 8-28-07; 95-876, eff. 8-21-08; 95-958, eff. | ||||||
5 | 6-1-09; 95-978, eff. 1-1-09; 95-1005, eff. 12-12-08; revised | ||||||
6 | 12-15-08.) | ||||||
7 | Section 20. The Illinois Insurance Code is amended by | ||||||
8 | adding Section 356z.15 as follows: | ||||||
9 | (215 ILCS 5/356z.15 new) | ||||||
10 | Sec. 356z.15. Inpatient hospital care. A group or | ||||||
11 | individual policy of accident and health insurance or managed | ||||||
12 | care plan amended, delivered, issued, or renewed after the | ||||||
13 | effective date of this amendatory Act of the 96th General | ||||||
14 | Assembly that provides coverage for inpatient hospital care | ||||||
15 | shall not refuse coverage for services provided to an enrollee | ||||||
16 | or recipient that are ordered by a physician in a hospital that | ||||||
17 | may subject the patient to observation status while undergoing | ||||||
18 | evaluation and assessment for the illness or condition that | ||||||
19 | resulted in their hospital stay. | ||||||
20 | Section 25. The Illinois Public Aid Code is amended by | ||||||
21 | changing Section 5-16.8 as follows:
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22 | (305 ILCS 5/5-16.8)
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1 | Sec. 5-16.8. Required health benefits. The medical | ||||||
2 | assistance program
shall
(i) provide the post-mastectomy care | ||||||
3 | benefits required to be covered by a policy of
accident and | ||||||
4 | health insurance under Section 356t and the coverage required
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5 | under Sections 356g.5, 356u, 356w, 356x, and 356z.6 , and | ||||||
6 | 356z.15 of the Illinois
Insurance Code and (ii) be subject to | ||||||
7 | the provisions of Section 364.01 of the Illinois
Insurance | ||||||
8 | Code.
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9 | (Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07.)
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10 | Section 30. The Medical Patient Rights Act is amended by | ||||||
11 | changing Sections 2.04, 3, and 5 and adding Sections 2.06, 5.1, | ||||||
12 | and 5.2 as follows:
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13 | (410 ILCS 50/2.04) (from Ch. 111 1/2, par. 5402.04)
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14 | Sec. 2.04.
"Insurance company" means (1) an insurance | ||||||
15 | company, fraternal
benefit society, and any other insurer | ||||||
16 | subject to regulation under the
Illinois Insurance Code; or (2) | ||||||
17 | a health maintenance organization , a limited health service | ||||||
18 | organization under the Limited Health Service Organization | ||||||
19 | Act, or a voluntary health services plan under the Voluntary | ||||||
20 | Health Services Plans Act .
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21 | (Source: P.A. 85-677; 85-679.)
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22 | (410 ILCS 50/2.06 new) | ||||||
23 | Sec. 2.06. "Health insurance policy or health care plan" |
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1 | means any policy of health or accident insurance provided by a | ||||||
2 | health insurance company or under the Counties Code, the | ||||||
3 | Municipal Code, the State Employees Group Insurance Act or | ||||||
4 | Medical Assistance provided under the Public Aid Code.
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5 | (410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
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6 | Sec. 3. The following rights are hereby established:
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7 | (a) The right of each patient to care consistent with sound | ||||||
8 | nursing and
medical practices, to be informed of the name of | ||||||
9 | the physician responsible
for coordinating his or her care, to | ||||||
10 | receive information concerning his or
her condition and | ||||||
11 | proposed treatment, to refuse any treatment to the extent
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12 | permitted by law, and to privacy and confidentiality of records | ||||||
13 | except as
otherwise provided by law. The patient has a right to | ||||||
14 | be informed at any time of his or her responsibility for | ||||||
15 | payment of services provided based on the inpatient, | ||||||
16 | outpatient, or observation status of the patient that may | ||||||
17 | affect coverage by his or her health insurance policy or health | ||||||
18 | care plan.
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19 | (b) The right of each patient, regardless of source of | ||||||
20 | payment, to examine
and receive a reasonable explanation of his | ||||||
21 | total bill for services rendered
by his physician or health | ||||||
22 | care provider, including the itemized charges
for specific | ||||||
23 | services received. Each physician or health care provider
shall | ||||||
24 | be responsible only for a reasonable explanation of those | ||||||
25 | specific
services provided by such physician or health care |
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1 | provider.
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2 | (c) In the event an insurance company or health services | ||||||
3 | corporation cancels
or refuses to renew an individual policy or | ||||||
4 | plan, the insured patient shall
be entitled to timely, prior | ||||||
5 | notice of the termination of such policy or plan.
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6 | An insurance company or health services corporation that | ||||||
7 | requires any
insured patient or applicant for new or continued | ||||||
8 | insurance or coverage to
be tested for infection with human | ||||||
9 | immunodeficiency virus (HIV) or any
other identified causative | ||||||
10 | agent of acquired immunodeficiency syndrome
(AIDS) shall (1) | ||||||
11 | give the patient or applicant prior written notice of such
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12 | requirement, (2) proceed with such testing only upon the | ||||||
13 | written
authorization of the applicant or patient, and (3) keep | ||||||
14 | the results of such
testing confidential. Notice of an adverse | ||||||
15 | underwriting or coverage
decision may be given to any | ||||||
16 | appropriately interested party, but the
insurer may only | ||||||
17 | disclose the test result itself to a physician designated
by | ||||||
18 | the applicant or patient, and any such disclosure shall be in a | ||||||
19 | manner
that assures confidentiality.
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20 | The Department of Insurance shall enforce the provisions of | ||||||
21 | this subsection.
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22 | (d) The right of each patient to privacy and | ||||||
23 | confidentiality in health
care. Each physician, health care | ||||||
24 | provider, health services corporation and
insurance company | ||||||
25 | shall refrain from disclosing the nature or details of
services | ||||||
26 | provided to patients, except that such information may be |
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1 | disclosed to the
patient, the party making treatment decisions | ||||||
2 | if the patient is incapable
of making decisions regarding the | ||||||
3 | health services provided, those parties
directly involved with | ||||||
4 | providing treatment to the patient or processing the
payment | ||||||
5 | for that treatment, those parties responsible for peer review,
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6 | utilization review and quality assurance, and those parties | ||||||
7 | required to
be notified under the Abused and Neglected Child | ||||||
8 | Reporting Act, the
Illinois Sexually Transmissible Disease | ||||||
9 | Control Act or where otherwise
authorized or required by law. | ||||||
10 | This right may be waived in writing by the
patient or the | ||||||
11 | patient's guardian, but a physician or other health care
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12 | provider may not condition the provision of services on the | ||||||
13 | patient's or
guardian's agreement to sign such a waiver.
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14 | (Source: P.A. 86-895; 86-902; 86-1028; 87-334.)"; and
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15 | by inserting immediately above Section 99 the following: | ||||||
16 | "Section 95. No acceleration or delay. Where this Act makes | ||||||
17 | changes in a statute that is represented in this Act by text | ||||||
18 | that is not yet or no longer in effect (for example, a Section | ||||||
19 | represented by multiple versions), the use of that text does | ||||||
20 | not accelerate or delay the taking effect of (i) the changes | ||||||
21 | made by this Act or (ii) provisions derived from any other | ||||||
22 | Public Act.".
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